A new assessment report released by Victims 2 Survivors and UNAIDS is looking at the structural and institutional response to gender-based violence (GBV) in Namibia.

The report was disseminated during the commemoration of Orange Day, observed across the world on the 25th of every month, which takes its title from the official colour of the United Nations Secretary-General’s Unite to End Violence against Women campaign. 

Gender-based violence (GBV) in Namibia: an exploratory assessment and mapping of GBV response services in Windhoek analyses the challenges encountered by survivors while trying to access services. It also makes key recommendations, including strengthening multisectoral coordination mechanisms, developing relevant standards and protocols to guide service provision, integrating GBV prevention and survivor support into reproductive health and HIV programmes and establishing a free national GBV helpline.

Bience Gawanas, Special Adviser to the Minister of Health of Namibia, emphasized the need for a change in the gender norms of the country and an end to tolerance for GBV. “Let us make the invisible visible, and give a voice to the voiceless.”

According to WHO, one third of Namibian women have experienced or will experience intimate partner violence during their life. Nine out of ten victims of domestic violence are women and 33% of young women who were sexually active before the age of 15 report that their first experience was forced.

In his address to the nation on 21 February, the President of Namibia, Hifikepunye Pohamba, highlighted concrete measures to be taken by the government to reduce the alarming increase of violence against women. These included amending constitutional acts to tighten the requirements for bail and denying parole and giving longer prison sentences to perpetrators of GBV.

President Pohamba also declared 6 March as the national day of prayer for action against GBV in Namibia. “The lives of too many women and girls have been destroyed or disrupted,” said President Pohamba. “Gender-based violence, in all its manifestations, should not be tolerated in Namibia. Let us join hands, to make our country safer, for all, including our women and girls.”

During the Orange Day event, Father Richard Bauer emphasized the importance of involving faith communities in the fight against GBV. “Faith leaders can be crucial allies if they are empowered to intervene, prevent and heal. It’s an incredible amount of work, but can become a reality, if we all work together and acknowledge our mutual strengths,” he added.

A new UNESCO publication explores the evolution of HIV education and how it can be made more relevant to young people.

Charting the course of education and HIV examines what has been learned in the AIDS education journey, its opportunities and challenges. It then proposes a way forward in an area that is seen to be critical to the success of the overall AIDS response.

According to UNESCO Global Coordinator for HIV and AIDS Chris Castle, “HIV education can help learners to not only develop and maintain safer behaviours, but also reduce stigma and discrimination towards people affected by, and living with, HIV.”

Exploring the mechanisms and machinations of culture, values, beliefs and relationships of power has become more prominent and acknowledging that education and health are inextricably linked is now seen as vital. For example, HIV education can help to tackle some of the structural drivers of the epidemic, such as harmful gender norms, which can increase the vulnerability of women and girls.

According to the book, one of the major lessons learned in AIDS education has been the need to broaden the scope of HIV education and ensuring a more open and holistic approach to it. In that respect, largely gone are the early tendencies to teach HIV as a science topic concerned only with the biology of transmission, along with the scare tactics often used to discourage young people from becoming sexually active.

Instead, skills-based approaches have emerged that stress communication and coping strategies. Using interactive, student-centred methods of teaching, rather than heavily didactic ones, has been proven to be more successful.

Nowadays, many countries have adopted the newer paradigm. A survey carried out across 13 countries in the Caribbean in 2008 found that all of them provide skills-based health education. Equally, all 21 nations in east and southern Africa have a policy or strategy to promote life skills-based HIV education.

However, the book shows that there is still a long way to go on the ground. Many young people across the world still do not possess even basic knowledge about the virus. HIV education often remains marginalized. Numerous curricula are found to be deficient, with little reference to key aspects of sex and sexuality and a lack of information about where to access relevant services. Often, teachers do not feel confident about delving into topics they may find embarrassing and do not allow their students the space to explore these issues in a frank and open way.

Charting the course of education and HIV recognizes the need to reframe HIV education to respond to such deficits and rethink teacher training and support and integrate skills-based activities with school health programmes. HIV education will also have to be adaptive to the changes in the epidemic and encompass not only HIV prevention but treatment, care, support, and stigma and discrimination. There should also be redoubled efforts to meet the growing demands from young people, and increasingly their parents, for comprehensive sexuality education, joining with ministries, school heads and other teachers to develop a common agenda to help young people make informed choices about how to live healthy and fulfilled lives.

Samir, a shy 15-year-old, has come a long way. Living in Uzbekistan and diagnosed as HIV-positive around a year ago he thought at the time his life was over. He felt hopeless and depressed. Now, however, he is looking forward to a brighter future thanks to his involvement as a peer-to-peer trainer in an innovative project spearheaded by UNAIDS and UNICEF in Tashkent.

During the most recent project workshop Samir joined 22 other adolescents living with HIV in the Uzbek capital. They were there to learn more about how to provide peer-to-peer support for other adolescents living the same experience in their home regions. 

The trainees learned more about HIV prevention, care and support services as well as the increasing availability of HIV treatment options and the related improvement in quality of life. Learning how to challenge stigma and discrimination, which are still very prevalent in Uzbek society was also on the agenda. Many people living with HIV still fear being rejected and so keep their status secret.

For Samir the programme has made all the difference and he is now much more confident and optimistic. “I’m proud of having two hands, two legs and a head and I’m grateful to be alive. The most important things are family, health and a job that you like,” said Samir who wants to work in a bank in the future.

The peer-to-peer educator initiative started two years ago and UNAIDS and UNICEF have already trained 37 young people and intend to have ongoing training for new HIV-positive adolescents as well as reinforcing the capacity of those already trained. According to UNAIDS Country Director for Uzbekistan and Turkmenistan Lev Zohrabyan, the programme is playing a crucial role. “This initiative provides an opportunity for adolescents diagnosed with HIV to not only effectively cope with their own status but to also become leaders in guiding other peers in effective integration into society and living a fulfilled life”.

For Robert Fuderich, UNICEF Representative in Uzbekistan, the programme provides a safe haven where young people whose lives have been impacted by HIV “have access to psycho-social support, medical and legal counseling and most importantly, to an environment free of stigma and discrimination.”

Although HIV prevalence in Uzbekistan is relatively low, with an estimated 0.1% of the adult population living with the virus, the country is in a region which continues to have the largest increase in newly registered HIV cases in the world.

Injecting drug use continues to drive the HIV epidemic in many countries around the world. According to the United Nations Office on Drugs and Crime (UNODC) in 2013 it was estimated that between 11 million and 22 million people inject drugs globally and that 1.6 million (1.2 million––3.9 million) were living with HIV.

In the 2011 United Nations General Assembly Political Declaration on HIV and AIDS, Member States committed to reduce transmission of HIV among people who inject drugs by 50% by 2015. However criminalization, stigma and discrimination remain widespread and continue to prevent people who use drugs from accessing essential HIV services.

Addressing participants at the High-Level Segment of the 57th UN Commission on Narcotic Drugs in Vienna UNAIDS Executive Director, Michel Sidibé emphasised the urgent need to provide effective services. “It is unacceptable that we are failing people who inject drugs,” said Mr Sidibé. “We have all the data to demonstrate that, in combination with antiretroviral therapy, essential services—including needle and syringe programmes and opioid substitution therapy—reduce HIV transmission, decrease mortality, and improve quality of life.”

Although people who inject drugs account for only 0.2–0.5% of the world’s population, they make up approximately 5–10% of all people living with HIV. However globally, less than 1% of people who use drugs have access to HIV treatment.

Participants at the roundtable discussion on demand reduction, which was chaired by Francisco de Asis Babin Vich, Head of the National Plan on Drugs at the Spanish Ministry of Health included representatives from UN Member States from some of the most affected countries. During the discussions Mr Sidibé made a strong call for harm reduction services to be implemented in all countries, particularly where HIV epidemics driven by injecting drug use exist. He cited excellent progress in China, where harm reduction is being scaled up in many parts of the country.

There was consensus among participants that demand reduction strategies should be based on scientific data and health. International drug treaties underscore that health is essential and drug control through repression of production and trafficking is not sufficient.  All stakeholders including civil society should be included and engaged in demand reduction policies and programmes according to participants at the roundtable.

As part of its continuing work to demonstrate the benefits of actively scaling up quality programmes that are based on human rights and public health needs, UNAIDS released an advocacy brief; Harm reduction works. The brief gives examples from around the world on the importance of investing in HIV prevention, treatment, care and support programmes for people who use drugs; the need to engage people who use drugs in programme development; and the importance of implementing strong and effective harm reduction programmes.

The Council of Arab Ministers of Health endorsed on 13 March the Arab AIDS Strategy (2014-2020) during its 41st Ordinary Session held at the League of Arab States. The new Strategy is intended to guide the development of a coordinated and consensus-driven regional response to HIV.

In his opening remarks, Nabil El Araby, Secretary General of the League of Arab States, noted the importance of the landmark achievement. “I congratulate the efforts made to finalize the Arab AIDS Strategy which began with a Saudi initiative and was concluded with the support of UNAIDS, international organizations and concerned civil society organizations,” he said.

The new strategy comprises 10 goals which are aligned to the targets set in the 2011 United Nations General Assembly Political Declaration on HIV and AIDS while maintaining a broader vision for an AIDS-free generation beyond 2015. The 10 goals of the strategy include: To reduce HIV incidence among key populations at higher risk of infection by more than 50%; to eliminate new HIV infections among children; to increase HIV treatment coverage to 80%; to address stigma and discrimination; to improve AIDS financing; to address the special vulnerability of women and girls; and to review the policies around travel restrictions.

In a resolution of endorsement, the Ministers of Health requested that the League of Arab States and UNAIDS work closely to support and monitor the implementation of the strategy at country level. The League will provide seed funding to kick-start the implementation of the strategy through the organization of three high-level forums to discuss issues related to women leadership, media and religious leaders.

“Health is one of the basic and principle rights for each individual without discrimination on the basis of ethnicity, religion or political, economic or social affiliation,” said Adel Adawy, Egyptian Minister of Health and Population. “Raising the level of public health for the whole society is principle to achieving peace and security.”

UNAIDS worked closely with the League of Arab States, the Kingdom of Saudi Arabia and other member states to provide political and technical support to develop the strategy. A series of consultations, workshops and technical validation meetings were organized as well as high-level advocacy conducted at regional and global level for the endorsement of the strategy by the Council of Arab Ministers of Health.

“The endorsement of the Arab AIDS Strategy demonstrates a longstanding commitment and leadership to the AIDS response in Arab countries,” said Yamina Chakkar, UNAIDS Regional Director for the Middle East and North Africa, on behalf of UNAIDS Executive Director Michel Sidibé. “We thank the Council for making the Arab AIDS Strategy possible and for being an important ally in helping to shape how we will work towards ending the AIDS epidemic in the post-2015 era,” she added.

The rise in new HIV infections makes the Arab region home to one of the fastest growing HIV epidemics in the world. Between 2001 and 2012, the estimated number of people living with HIV in the League of Arab States member countries increased from 140 000 to 210 000. Since 2001, the number of people newly infected with HIV in the Arab countries has increased by more than 44%—from 18 000 to 26 000—and between 2001 and 2012 there was a 69% increase in AIDS-related deaths in this region.

Existing discriminatory laws, policies and practices as well as negative attitudes among health practitioners are some of the main obstacles impeding access to health services for many people.

This is one of the main conclusions coming out of a debate convened by UNAIDS on 11 March to explore how discriminatory barriers to health services affect different population groups including people living with HIV, undocumented migrants, transgender persons, and persons with disabilities.

For migrant people discrimination often starts at the point of departure, where pre-departure regulations can include mandatory testing for HIV, pregnancy and other health issues. To avoid these tests, migrants may opt for irregular channels of migration, thus becoming undocumented and unable to access health services.

For transgender persons, discrimination is embedded in the International Classification of Diseases, which considers transgender as a mental illness. In many countries, including more than 20 in Europe, transgender people are forced to go through sterilization before gender reassignment surgery in order to change their gender identity.

Speaking about the possible lack of understanding about transgender issues among the medical profession, Mauro Cabral from the Global Action for Trans Equality (GATE) stressed that, “ignorance cannot be an excuse anymore. Doctors must respect, and not judge, patients.”

Another common barrier identified was the perception among the general population in many countries that resources invested in health services are ‘wasted’ on such groups which many in society consider ‘less deserving’.

Monitoring and documenting discrimination was stressed as a strategy to generate evidence to address the problem. In this regard, the Stigma Index and Human Rights Count were highlighted as tools which have been successfully used to monitor discrimination against people living with HIV. For example, the Human Rights Count tool, revealed the practice of involuntary sterilizations of women living with HIV.

“When communities are given the space and opportunity to engage in human rights monitoring, the real obstacles of why people are not accessing health services can be identified and addressed,” said Chris Mallouris, community mobilization adviser at UNAIDS. “We must ensure that communities are at the centre of efforts to address discrimination. They must be there as equal partners,” he added.

The panel debate concluded with a sobering recognition of the long journey ahead to achieve zero discrimination. Participants recognized that action needs to be scaled up to overcome barriers to health services and that no one should be left behind if global health targets are to be achieved.

On the eve of International Women’s Day, UNAIDS, the Hotel InterContinental Genève and the Rudra-Béjart School of Dance came together to promote health equity and to ensure that women and girls living with HIV are not left behind.

The Rudra Béjart's School of Dance with the pianist Melodie Zhao presented an exclusive performance about gender equality and women’s empowerment created to commemorate the International Women’s Day (8 March). "For this event, I asked my staff to create choreographies that show the ‘men-women, harmony’ theme,” said Michel Gascard, Director of the Rudra Béjart's Dance School.

Throughout the evening the audience saw different pieces created by a variety of choreographers ranging from classical and improvised dances to songs in Russian—a reminder that the Women's Day date stems from the empowerment of the women in Russia in 1917.

“This event is an illustration of how the world of art, the private sector and the United Nations can join forces in support of women and girls living with HIV,” said Mariangela Simao, Chief of rights, gender and community mobilisation division at UNAIDS.  “If we want to achieve our vision of zero new HIV infections, zero AIDS-related deaths and zero discrimination we need many partners and friends from different sectors,” she added.

The celebration is one of the events planned for 2014 as part of the joint UNAIDS and the Hotel InterContinental Genève campaign ‘Where History is Made’—which aims to raise awareness and funds for the elimination of new HIV infections among children and keep mothers alive.

“Since launching our joint campaign in December, we at the InterContinental and many of our guests feel part of the global AIDS response”, said Jürgen Baumhoff, General Manager of the Hôtel InterContinental Geneva. “It has inspired us to be more actively involved with UNAIDS to achieve an AIDS-free generation.”

Gender inequality, including gender-based violence is a key risk factor for HIV among women. As a result, women and girls bear a disproportionate burden of the HIV epidemic. Globally, young women aged 15–24 are most vulnerable to HIV, with infection rates twice as high as in young men. According to UNAIDS, every hour 50 young women are newly infected with HIV and up to 45% of adolescent girls around the world report that their first sexual experience was forced. 

The Rudra Béjart's School of Dance is a private international free school sponsored by Sandoz, Béjart Ballet Lausanne, Loterie Romande, Fondation Leenaards, Béjart, Jaquet Droz.

Studies have shown that intimate partner violence can increase the risk of HIV infection by around 50% and that one in three women experience violence by their intimate partner during their lifetime. There is also evidence that violence, or the fear of violence undermines access to treatment, care and support services for women living with HIV.

In efforts to address the complex linkages between violence and HIV, in a statement, the United Nations Secretary-General Ban Ki-moon called on the world to do more, “We must take action to end violence against women and girls and ensure that they have the sexual and reproductive health and rights that they deserve. Violence has a drastic impact on the health of women and children and is inextricably linked to a higher prevalence of HIV. That is why I have made ending violence against women and girls a top priority for the United Nations.”

The Secretary-General’s call was amplified at the high-level panel Linking HIV, gender equality and sexual and reproductive health and rights as part of the Every Women Every Child initiative, and the post-2015 social justice agenda organized by UNAIDS during the 58th Commission on the Status of Women held in New York. “Not only is violence against women an extreme human rights violation, it also makes women more vulnerable to HIV infection,” said Michel Sidibé, Executive Director of UNAIDS. “Post-2015 is the opportunity to ensure all women and girls reach their full potential, without the threat of violence, risk of HIV infection and violation of their sexual and reproductive rights.”

The event, chaired jointly by Mr Sidibé and the Executive Director of UN Women Phumzile Mlambo-Ngcuka, encouraged dialogue around the critical need for women-centred efforts to end the AIDS epidemic; the advancement of sexual and reproductive health and rights for women; gender equality and women’s empowerment; and zero tolerance for gender-based violence. “The single most important strategy in dealing with HIV is empowering women and protecting their rights,” said Ms Mlambo-Ngcuka.

Panellists included HRH the Crown Princess Mary of Denmark, Ministers of Gender Equality from Ghana, Malawi, Brazil and a representative for young women living with and affected by HIV from Algeria. "In my region, discrimination is a societal phenomenon. We must continue to act to eliminate discrimination—it’s the key to the end of the AIDS epidemic,” said Fatima Bendida, El Hayet Network of People Living with HIV, Algeria.

The panellists also elaborated on the importance of addressing stigma and discrimination. They stressed the need to end violence against women for their own health, as well as to prevent new HIV infections. They also emphasized the particular focus needed on young women and girls to ensure they have access to comprehensive sexuality education that all women living with HIV have access to treatment, care and support, within a rights-based and social justice framework.

“It is essential that we achieve universal access to integrated sexual and reproductive health information, education and services, fully addressing HIV, based on gender equality and with zero-tolerance for gender-based violence,” said HRH Crown Princess Mary of Denmark, Patron of UNFPA and Member of the High Level Task Force for the International Conference on Population and Development

The panellists also highlighted poverty as a driver of HIV and sexual and reproductive ill-health and recognised equity in access to services as a key focus for development for women. They also emphasized the continued need to secure funding for the most marginalized in societies.

Ms Nancy Mahon, Executive Director of the M·A·C AIDS Fund moderated the event at which Mr Sidibé launched a UNAIDS Advocacy Brief: Unite with women unite against violence and HIV. The brief outlines five core reasons to prevent violence against women; violence against women is a human rights violation; women who experience violence are more likely to acquire HIV; women living with HIV are more likely to be subjected to violence; women most vulnerable to HIV are also most vulnerable to violence; and that violence undermines the HIV response by creating a barrier to accessing services.

The discussions at the panel event were an important milestone in the ongoing post-2015 debate, underlining the central role women living with HIV need to play in the discussions around the post-2015 debate.

The United Nations Secretary-General Ban Ki-moon met together with his team of United Nations Special Envoys on HIV/AIDS to discuss their strategic directions for the year ahead. UNAIDS Executive Director Michel Sidibé also participated in the meeting that took place on 10th March 2014  at the United Nations Headquarters in New York.

Welcoming his second meeting with the Special Envoys on HIV/AIDS since their appointment in 2012, the Secretary-General thanked them for their continued commitment and well-coordinated leadership and advocacy. Mr Ban said, “I commend you all for your excellent work in 2013 and am very pleased to learn that you are working closely with other Special Envoys, Special Representatives and Rapporteurs to advocate for and create synergies between your work. I am also happy to learn that you have worked closely with UNAIDS to develop specific strategic directions for 2014.” Mr Ban also welcomed the latest member of the team, Speciosa Wandira-Kazibwe.

“They are a dedicated and cohesive team and have been instrumental in advancing efforts to achieve the Millennium Development Goals,” said Michel Sidibé Executive Director of UNAIDS. “They also greatly support the Secretary-General and his call for a life of dignity for all and leaving no one behind.”

The Special Envoys on HIV/AIDS are formed by Speciosa Wandira-Kazibwe, Special Envoy for Africa; Michel Kazatchkine, Special Envoy for Eastern Europe and Central Asia; J.V.R. Prasada Rao, Special Envoy for Asia and the Pacific; and Edward Greene, Special Envoy for the Caribbean.

“We have an effective team with great coherence, and a deep understanding of regional specificities and global issues, and are able to work across areas of development beyond HIV,” Mr Ban added.

Their main areas of work are prioritizing to ensure the prominence of HIV in thematic areas are on drug policy, human rights, stigma and discrimination and the empowerment of women and girls.